State Telemedicine Policy Information
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Arizona Telemedicine Policy
Arizona Telemedicine Policy
A leading center of innovation in the United States, Arizona is on the fast track for improving telemedicine coverage. The Arizona Telemedicine Program at the University of Arizona regularly meets with Arizona legislators to report on enhancements and innovation in telemedicine and discuss potential changes to the state laws. Arizona is unique because of its partial telemedicine parity law. In other words, the state requires private payers to reimburse for telemedicine, but only for ‘rural’ areas and specific health care services. Ready to find out more about Arizona’s telemedicine policy? Keep on reading.
State Policy Overview
Medicaid
Yes
Private Payer
Yes
Parity
Yes
Additional State Telemedicine Info
Parity Laws
Arizona has a partial telemedicine parity law. The law requires reimbursement through private payers, but only for certain health services delivered to patients in rural areas of Arizona. The law specifically defines a “rural” area as a region or city located in a county of less than nine hundred thousand people. Many private payers will still cover telemedicine outside rural areas. Check with your commercial payers on their policy for telemedicine services.
Medicaid
AHCCCS covers medically necessary consultative and/or treatment telemedicine services for all eligible members within the limitations described in this manual when provided by an appropriate AHCCCS registered provider. With few exceptions, reimbursable consultations must be provided in a real-time. For more information, view the AHCCCS Telehealth Training Manual.
Type Of Telemedicine Covered
Arizona Medicaid covers live video, store-and-forward, and home health monitoring telemedicine.
Covered Health Services
Arizona requires private payers to cover the following health services when they are delivered via live telemedicine to patients in rural areas:
- Trauma
- Burn
- Cardiology
- Infectious disease
- Mental health disorders
- Neurologic diseases including strokes
- Dermatology
- Pulmonology
- Pain medicine (starting 2019)
- Substance abuse (starting 2019)
- Urology (starting 2020)
Arizona Medicaid (AHCCCS) will reimburse for medically necessary services provided via live video, including:
- Cardiology
- Dermatology
- Endocrinology
- Hematology
- Home Health
- Infectious diseases
- Neurology
- Obstetrics/Gynecology
- Oncology
- Ophthalmology
- Orthopedics
- Pain clinic
- Pathology
- Pediatrics and pediatric sub-specialties
- Radiology
- Rheumatology
- Surgery follow-up and consults
- Behavioral health services, including:
- Diagnostic consultation and evaluation
- Psychotropic medication adjustment and monitoring
- Individual and family counseling
- Case management
- Inpatient consultation
- Medical Nutrition Therapy
- Surgery follow-up consultations
- Pain management
- Pharmacy management
For more information, check out your Arizona Medicaid Manual.
Eligible Healthcare Providers
Not all healthcare providers can do telemedicine under Arizona Medicaid. Here’s the list of the eligible providers:
- Physician
- Registered nurse practitioner
- Physician assistant
- Certified nurse midwife
- Clinical psychologist
- Licensed clinical social worker
- Licensed marriage and family therapist
- Licensed professional counselor
Providers also must be licensed in Arizona and currently enrolled in the Arizona Medicaid program
Online Prescriptions
Doctors are not allowed to issue a prescription without a physical or mental health examination to establish a relationship with the patient.
Informed Patient Consent
Arizona requires providers to get a patient’s oral or written consent before a telemedicine visit and note that in the patient’s record.
Cross-State Telemedicine Licensing
Arizona is part of the Interstate Medical Licensure Compact, an effort to make cross-state licensing easier.
Restrictions On Locations
According to Arizona’s parity law, private payers are required to provide coverage when the originating site (where the patient is) is located in a rural region, defined as an area or city with a population of less than nine hundred thousand persons.
Under Medicaid, the provider must be delivering telemedicine at one of the following locations:
- IHS clinic
- Tribally-governed 638 facility
- Urban clinic for Native Americans
- Office of a physician or other practitioner
- Hospital
- Federally qualified health center (FQHC)
Reimbursement Rates
In 2015, Arizona Medicaid started reimbursing for telemedicine services according to the current physician fee schedule amount for that medical service. Additionally, Arizona requires private payers to cover live video telemedicine when the patient is in a rural region and is receiving treatment for one of the following conditions:
- Trauma
- Burn
- Cardiology
- Infectious disease
- Mental health disorders
- Neurologic diseases including strokes
- Dermatology
- Pulmonology
- Pain medicine (starting 2019)
- Substance abuse (starting 2019)
- Urology (starting 2020)